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My 24-year old daughter is in the hospital for the second time since October. She has been in IOP twice. She's still not able to stay in school or work. She is starting to consider residential treatment. I got a huge list from the BPD Resource Center (thank you!) and researched all of them. Does anyone know someone who's been through it successfully? It's SOOOO expensive and would exhaust all her college and living funds if we pursue it.

Hi newtoFL and welcome to the group  :hi:

Glad to hear that you found a list of options, and that your D24 may be open to residential.

We did have a staff member whose teen daughter attended Falcon Ridge; you can read her story here: Residential Treatment: Journal of 12 Month Journey (https://bpdfamily.com/message_board/index.php?topic=120563.0)

hope that's a good starting point for info and background.

Does your D24 have a BPD diagnosis? Is she accepting of it?

Thank you! Unfortunately, Falcon Ridge is for adolescents but it did sound great. I found about a half dozen on the list from the BPD Resource Center that seem especially promising (a few were non-starters due to cost). She was diagnosed (4  years ago? she won't tell me for sure) and seems to finally be accepting of it but is not very hopeful residential will help, although she told the hospital psychiatrist she has never had treatment for BPD. She is being VERY defiant and ugly to the hospital staff. I pray she stays put (she's there voluntarily) to get stabilized.

NewtoFL -
We have experience with an intensive inpatient program.  We narrowed to the following:
Austen Riggs (Stockbridge, MA)
Cooper Riis (Ashville, NC)
McClean Hospital (Cambridge, MA)

We ultimately let her choose the treatment center (Cooper Riis) so that she would be a part of the process and hopefully commit. She did not commit.
After going for < 60 days she checked herself out and went on a trip.  We lost the money we invested in it. I do feel it was a good program and could work if the patient commits.

We have since paid for two different BPD-focused Intensive Outpatient Programs and both of the Psychologists decided that they could not move forward if SD would not commit to work on herself.
The last Psychologist suggested we try another Inpatient Program but we cannot justify the financial risks we would have to take to pay out that much again with no commitment on her side.

Good luck. I hope you have better luck than we have.

StepMothering,

My heart breaks for you. Since I initially posted, her new eating disorder has become the most pressing issue as her BMI has rapidly reached a level that the facilities that treat BPD cannot accept her. Luckily, she is now sufficiently scared such that she is even more agreeable to treatment. We are trying to get her out of this horrific inpatient hospital that is doing nothing for her. I realize that once the eating gets addressed, we may lose the momentum to address the BPD, but time will tell.

Thank you for your transparency.

NewtoFL, even though your daughter is 24, has she signed off on you (parents) communicating with her doctors?

If so, and if getting her into eating disorder treatment is an option, I wonder if you can collaborate with the ED team so that her next step after ED treatment isn't "take a taxi home" but is direct transfer to a BPD treatment facility?

Maybe that's an ideal situation -- but on paper, at least, it seems like it'd be easier for her to transfer from ED trxmt to BPD trxmt than ED to home to BPD. Hard to say, and depends on how open an ED treatment team would be with parents. Some better regarded ED treatment centers do take a "family centric/family inclusive" approach, though sometimes the focus is on the <18 crowd so it may differ for young adults.

I suspect that while ED treatment staff may not openly talk about it, they are well aware that eating disorders are not the only challenges their clients have.

Hope you and your family can ride this wave of your D24 being open to some help.

Thank you, kells76!

Your message was so encouraging, because that is the current plan! She DOES seem committed. Her BMI is such that she cannot go directly to the preferred residential BPD treatment facility, but THEY recommended an eating disorder facility. She will be going there Monday, and after completion, transfer directly to the BPD program (that was reiterated by both the ED and BPD facilities). She did authorize us to talk to her "providers" (I use the term loosely) while she was hospitalized; I pray that continues at the follow on facilities. So far, both intake coordinators have been talking to me regularly as we work to get her there. This will be the longest 4 days and nights of our lives as we ride the waves with her until she's on that plane.

Sounds like the "least bad" plan for her right now. I hope that even if she doesn't express it, that at some level she feels relief at being in treatment settings. There can sometimes be outward/verbal resistance but a secret feeling of "whew, I'm actually glad to be here". If there are peers, too, that she can engage with in group therapy or other multi-person therapeutic settings (art therapy, OT/PT, outings, etc), that can sometimes help: "I hate it here but Jane is going through this too and understands me".

Is she staying with you until you all get on the plane?

And can you remind me if you've seen the NEABPD's  (https://www.borderlinepersonalitydisorder.org/)Family Connections program (https://www.borderlinepersonalitydisorder.org/family-connections/) materials before? If you haven't, their "Family Guidelines" (https://www.borderlinepersonalitydisorder.org/wp-content/uploads/2011/08/Family-Guidelines-standard.pdf) for when a child is in treatment may give you some good ideas for how to communicate and support effectively while she's in the programs.

Hang in there -- hope you get to relax some and catch your breath once she starts the ED program.

Hi NewtoFL,

My diagnosed stepdaughter did residential treatment at McLean.  At the time, I think she wasn't ready for treatment; rather, she merely went along with it, and felt forced into it.  Though the program was comprehensive and helped stabilize her in the short term, my stepdaughter didn't engage with the follow up, and maybe the McLean staff weren't forceful enough about ensuring that she continued with the recommended treatment plan.  So it might have seemed to be a waste.

Later, my stepdaughter hit bottom, and she became more committed to therapy, as it became her only viable alternative.  A key turning point was authorizing her dad to obtain information about her care.  At the same time, he realized that his primary role was to help ensure that she stuck with therapy.  You see, historically my stepdaughter would make all the decisions about her life, and she'd quit or drop out of most everything early--school, work and therapy--as she was highly impulsive, emotionally unstable and not thinking clearly.  A prior poster referenced how her daughter dropped therapy because she wanted to go on a trip.  My stepdaughter did the exact same thing, seemingly not caring one bit about the thousands of dollars wasted on a program.  But now, going forward, her dad would intervene and say, "You need to do what the doctors are telling you to do; right now isn't the time for a trip.  You need to focus on therapy so that you can feel better."  Since she had hit bottom, she was more cooperative and committed to the process.  She also had to hear an ultimatum--she was free to do what she pleased, but if she didn't commit to therapy, she'd be on her own.  For her, the choice became an easy one.

One other aspect that helped was alleviating my husband from the burden of coming up with solutions.  It seemed he had tried everything to help his daughter, and yet nothing seemed to work.  When I told him, "Your daughter clearly isn't well, and she needs professional help.  The professionals will know what to do--there are millions of people with mental issues, and the doctors have surely seen all this before.  Your job right now is to make sure your daughter does whatever the doctors tell her to do.  She can't make decisions in her own best interests right now, because she's not thinking straight!  Your job is to make sure she follows doctors orders."  That seemed to provide him some needed comfort and guidance.  By the same token, my stepdaughter seemed to warm to the idea of getting help from professionals.  Maybe it fed into her victim mentality, or the notion that nobody understands her or validates her; I'm not sure.  But I could see her perspective:  she must have been exhausted by getting "help" and unsolicited advice from her family all the time, and maybe the advice from professionals wasn't tainted by all the familial baggage.

I guess what I'm saying is that a residential treatment can be successful, but only if your daughter is committed to the process.  If she's unwilling to go, or she's at a risk of dropping out early, then it's probably not worth the money.  For therapy to work, she needs to do the work, because therapy IS work.

Anyway, with intensive therapy, my stepdaughter is doing much better now.

Hope she got on the plane with you and is in the facility now. Keep us posted but no pressure for when. I know you probably have a lot going on right now.

Thank you, Kells and CC43!

Your words and stories have been a real salve to my heart! YES--she's in place! The 3+ days between being released from the hospital and getting on the plane for residential treatment were a rollercoaster, but thanks to my Family Connections training and wonderful BPD books, I was able to stay calm while she cycled. Her stepdad and I just kept reminding her that she made the only logical decision and had no viable alternatives since she's done therapy, IOP, ER visits, and even hospitalization but never with BPD experts. The detour through an ED program was unexpected, but I think necessary because she's so convinced something is medically wrong (unrelated to eating); she wasn't/isn't in a position to focus on the BPD yet. Once she was on the plane, I think she experienced exactly what you described, Kells. She was fighting it hard but once she was on the plane, I believe tehre was relief!

So much of CC's story touched on familiar themes: I definitely did too much "coaching" in the past so she didn't own anything. I was very cognizant of putting her in the driver's seat this time: she took herself to the hospital and allowed them to keep her in the ward for over a week, she made the call for residential, she researched the options, she did the interviews. I am somewhat concerned that this could be an adulting stall tactic (stopped going to school and wasn't allowed by her dad to have a job), but I pray that even if that's partially true, her commitment to wanting to get better--physically and mentally--will prevail and she will get the help she so desperately needs. I know we have a long road. Any advice on how to keep her committed and motivated--while not making it OUR idea--would be appreciated.

Kells, I printed out the document from McLean that you were so kind to link, but I didn't see anything specifically on support WHILE the child is in a residential facility...?

Thank you so much (and for your patience while I caught my breath--sadly, our 15-year old pup is entering his last days so it's been A LOT).

All, we're at the week+ mark at the ED facility and she's over it. Her angry BPD is coming out since she's being asked to work (she went from her own apartment with no obligations--paid for by dad--into a roommate situation where each hour of your day is scheduled). She's announced she will NOT be transferring to the BPD residential treatment facility. Of course I will continue to pray that she will stick with it and have a change of heart...but what if she doesn't? Am I allowed to say "I love you, but you're on your own if you won't accept treatment"? I cannot continue to ride the roller coaster with her, be the one she calls daily to rant, blame, and have panic attacks with. Do I NEED to remove myself--her ONLY person--to get her to hit bottom? It seems contrary to everything I've read and learned about BPD but to continue to allow her to use me as her receptacle only seems to be enabling her, and taking a tremendous toll on me. And I cannot get her dad to communicate with me. He'll presumably continue to fund her non-life lifestyle until her college fund runs out....

Ouch, that has to hurt to hear her be "over it", after all you've done to try to care for her.

Not sure if I've mentioned this -- I did ED treatment in high school & college. I remember calling my mom not long after the start of my college IOP, and being really mad about how I had to quit the job I loved to go to it, even though they promised I could still work and attend. I think I was swearing to (not at) my mom on the phone. But I stuck it out.

It might be a normal part of the acclimatization process for a patient to get really angry near the start of treatment. It might help to remember that the way she feels in the moment now isn't necessarily exactly how she will act in the future. She may be saying all kinds of things about not going to BPD treatment... but you'll know more on the day of, not now. She might resist... but she might not.

One option is to listen and validate the valid, without any explanations, convincing her of stuff, consequences, threats, ultimatums, lessons, etc.

"Yeah... it does sound like it sucks" -- and leave it at that. No "but it's for your own good" or "but you'll be on your own if you don't" etc. Could that be do-able, to just listen?

Are you in touch with the ED staff? If so, what have they said about the situation?

How much longer will she stay at the ED facility?

Thanks for the quick response, Kells! Thank you for sharing your ED experience; you hadn't mentioned it prior. I was *hoping* this could be the transition phase (like a college student going away and getting homesick?!?). I realize I shouldn't borrow trouble. As you say, don't stress until what she's threatening comes to pass...and the majority of the time it DOESN'T come to pass! You think I'd learn by now.

The ED staff has not contacted me. I have only spoken with the intake coordinator who assures me it's not as bad as she's telling me, nor as one-sided. No surprise. The minimum stay appears to be one month--maybe even two--but I want to keep them--and my daughter--focused on transferring to the BPD facility ASAP.

BUT...I do want to have a script if the worst does happen. Any suggestions on how to set boundaries if a BP doesn't complete treatment???

Hi again FL,

I can relate to your situation of feeling you enable a "non-life" life.  My stepdaughter also lived like that, but I happen to call it her perma-vacation period.  The thing is, when living with no schedule or obligations, you'd think she'd enjoy it, correct?  Ironically, she was very depressed during her "perma-vacations."  You might think, she was depressed, so she didn't do anything.  I think it was exactly the opposite--she didn't do anything, so she was depressed!  Her BPD thinking went into overdrive, and she'd lash out at her family, blaming them for her situation.  In a way, the "non-life" mode of living is one of avoidance.  She's avoiding real life, real friends and real feelings.  It's procrastination, super-sized.  Do you know what happens when you do nothing?  You feel like nothing.  It's not a good feeling for anyone.

I often felt that my husband was "enabling" his daughter live her non-life for far too long, because he didn't force her to work part-time, or help out at home, or take responsibility for any of her bills.  It seemed that the sicker she got, the more spending money she got from him.  Perversely, she was "rewarded" for bad behavior.  She got her own apartment, unlimited vacation time, and travel abroad.  She got tuition, but dropped out of school multiple times, staying only for the spring breaks and parties.  Meanwhile, my husband cut the cable at our house, to economize.  We couldn't afford the occasional take-out sushi, while she ordered regularly from DoorDash, as if she were too busy to cook for herself.  Can you hear the resentment in my text?  I really resented that.

I understand that adulting is hard, and it's probably too much to expect a young adult to be completely independent at first.  But I don't think that BPD should be deemed so disabling that she can't work or even be civil.  If her BPD is that bad, and her judgment is so poor, and her emotions are so out of control, then she probably shouldn't be driving.  My opinion is, if she is capable and responsible enough to drive a car, then she is capable and responsible enough to work.  Does that sound fair enough?  You could look at it another way:  what will she do when you're gone?  A parent's main job is to teach their kids to be independent adults.  If they are so incapacitated, then you might have to look into setting up a trust fund and enrolling for disability.  For most people, that probably would preclude college education and a separate apartment.

Look, my stepdaughter tried doing things her own way.  She wanted independent living and education, and she failed massively.  Most parents can't afford to finance that lifestyle indefinitely.  At one point, my husband was working well past his retirement age so that his BPD daughter didn't have to work at all.  But he wasn't ready to continue working until his death.  And upon his death, what would she do then?  Clearly he wanted her to learn to gain independence, that's his main job as a parent!  So there came a time for an ultimatum.  She could choose to do whatever she wanted instead of get treatment, but if she chose that, she'd be on her own financially.  I think her choice was easy, because she had tried doing whatever she wanted and failed miserably.  The pain of another failure was too much, for her (and for us).

I know quite a few parents who have children with drug addictions.  Would you continue to give your children money, if they were buying illegal drugs with it and destroying their life, along with yours?  What most of these parents come to realize is, that they will help their children to get clean.  Otherwise, they're on their own.

I know how heart-wrenching the whole situation is.  I'm happy to say that our situation is much improved now, after my stepdaughter decided to take therapy seriously.  

Good morning, CC! I feel like our stories are VERY similar. The difference in my situation is that it's my ex-husband who is funding her lifestyle of emptiness while I am trying to encourage treatment and engagement. Unfortunately, he who holds the gold makes the rules hence the working at cross purposes comment I made earlier. It's hard to stand by and watch, knowing that he will likely cut her off cold turkey financially, or force her to do something she's not capable of doing (e.g., enroll in school full time or get cut off). He will not talk to me so I cannot tell him that it's a recipe for failure. Praying that through treatment, she will be able to advocate for herself and propose a plan that works for her that her dad will support. Your messages really do give me hope that you can have a productive life with BPD. I'm soooo happy to hear that your SD is doing better and that there are indeed more good days than bad! You are a saint for hanging in there with your husband while you watched him struggle with how to effectively support his daughter! That could NOT have been easy!

Hi FL,

Yes it was hard to hang in there, as I hated seeing my stepdaughter self-destruct, always making impulsive decisions that weren't in her own best interest.  I guess she was set on alleviating short-term pain and discomfort.  When she did that, she'd feel bad about herself, and rather than have her self-doubts eat her alive, she turned around and hurled her hatred towards her family and friends.  She must have known her behavior wasn't conducive to maintaining relationships or getting what she wanted, but I think it was her way of telling us how much she was suffering.  Even so, "adult tantrums" aren't attractive or easy to deal with.

I love my husband, but we didn't always see eye-to-eye about what to do about the situation.  I suggested that he (or we) get some therapy, to deal with the pain and frustration, but my husband isn't much of a talker.  He's more traditional man, a "provider" rather than a "nurturer," and I think that he thought, if he just set her up in the perfect apartment, with the perfect school, and spending money for the latest phone, clothes, TV programs, take-out food and tuition, that her stress would be minimized, and she'd feel confident and get on with life.  But as you know, with BPD, things aren't that simple, and even if she had an infinite supply of spending money, she couldn't function well, not without learning coping skills and extensive therapy.  Many of the coping skills that she needs to learn are counter-intuitive.  That's why I've found this site to be a good source of tips, and of consolation when things don't go so smoothly.

It must be hard for you not to be on the same page as your ex concerning your daughter.  That also happened with my husband's ex.  She is a high-conflict person and not a good role model for her daughter.  I'm not sure what to tell you about how to strategize about going forward.  One aspect that I thought was very damaging was my stepdaughter's tendency to run to the other parent (or household) whenever she didn't get what she wanted.  By doing that, she avoided dealing with the issue, while at the same time "punishing" the offending parent by storming off and cutting off contact.  This went on for years, basically ever since she got a car and was free to travel between residences.  I don't think it helped one bit.  Nevertheless, when her behavior got really bad, I was secretly relieved when she went to her mom's.  I hate feeling that way, because I want what's best for my stepdaughter, but at the same time, living with her was H-E-double-hockey-sticks.

Maybe what you focus on is what is under your control.  You can control your interactions with your daughter, and what financial support (if any) you provide.  I will say that since I'm not my stepdaughter's parent, I try to avoid "helping" her or "fixing" things for her, unless I'm asked.  It must feel horrible to be reminded of her psychological issues all day.  I try to keep the conversation light and as normal as possible. And I try to keep my expectations low--I "age-adjust" them for her emotional age--so that I don't appear to be disappointed in her.  For example, I don't expect her to help around the house, and I don't expect her to be courteous.  I don't ever expect a reply to a text (like a dinner invitation).  I don't expect her to be up to date with the news.  I don't expect her to know what insurance is, or how much rent costs, how to go about finding a job, how to check the account balance of a debit card, or to know when election day is.  She gravitates towards things that my young nieces talk about--Harry Potter, TV, nail polish, etc.  So I try to engage with her at her level.  Having said that, my young nieces go to middle school (full-time) and participate in extracurriculars (dance, sports).  They get up in the morning, get dressed on their own, eat as a family at mealtime, do homework, tidy their rooms and take baths daily.  They might still need a little guidance (like reminders to get their backbacks organized for the school day), but they are generally pretty good about staying on schedule, more or less autonomously.  They have outgrown the age of crying over minor squabbles and disappointments.  In contrast, my stepdaughter still can't seem to handle a full-time schedule like that, and she'll still cry over seemingly insignificant setbacks.  So sometimes I see her as an 11 or 12 year old, in terms of executive function and emotion control.  So I guess I'm saying, if I adjust my expectations, I'm less frustrated about her behavior.  And by thinking in terms of emotional age, I guess I see the opportunity for her to mature in the future, so I don't lose all hope.

To wrap up, there are a couple of issues that I saw as obstacles to my stepdaughter facing reality and getting help.  First, I'd say that excessive spending money was detrimental.  Having so much spending money meant that she was able to buy marijuana and afford unlimited streaming apps on TV.  As a result, I believe she was highly "entertained" while living her non-life.  I think it's hard to find motivation to do hard things (like work or college studies) when the lure of drugs and sedentary entertainment is available 24/7.  If it were up to me, she would have to earn the money for luxuries (like her phone, streaming apps, manicures, etc.)--at least then, she'd have to work part-time.  And if she's using money for drugs, I'd make sure not to give her cash.  Rather, I'd pay for things in kind--like paying for rent directly, sending food deliveries, etc.  And while she was living in my home, I'd turn off the internet at nighttime or confiscate any phones I'm paying for, to ensure she wasn't up all night doom-scrolling on her phone.

I hope this helps a little bit.  You're not alone.